Transient Tachypnea of the Newborn (TTN)

What Is Transient Tachypnea of the Newborn?

Some newborns have very fast or labored breathing in the first few hours of life
because of a lung condition called transient tachypnea of the newborn (TTN).

Babies with transient tachypnea (tak-ip-NEE-uh) will be closely watched in the
hospital and some might need extra oxygen for a few days. Most babies make a full
recovery. TTN usually does not have any lasting effects on a child's growth or development.

What Causes Transient Tachypnea of the Newborn?

While inside the mother, a developing fetus does not use the lungs
to breathe — all oxygen comes from the blood vessels of the placenta. During this
time, the baby's lungs are filled with fluid.

As the baby's due date nears, the lungs begin to absorb the fluid. Some fluid also
may be squeezed out during birth as the baby passes through the birth canal. After
delivery, as a newborn takes those first breaths, the lungs fill with air and more
fluid is pushed out. Any remaining fluid is then coughed out or slowly absorbed through
the bloodstream and lymphatic
system.

In babies with TTN, though, extra fluid stays in the lungs or is cleared out too
slowly. This makes it harder for a baby to breathe in oxygen properly. As a result,
the baby must breathe faster and harder to get enough oxygen into the lungs.

Who Gets Transient Tachypnea of the Newborn?

babies born via rapid vaginal deliveries or C-sections
without labor. They don't undergo the usual hormonal changes of labor, so their lungs
don't have time to absorb much fluid.

babies whose mothers have asthma or diabetes

What Are the Signs & Symptoms of Transient Tachypnea of the Newborn?

Symptoms of TTN include:

very fast, labored breathing of more than 60 breaths a minute

grunting or moaning sounds when the baby breathes out (exhales)

flaring nostrils or head bobbing

skin pulling in between the ribs or under the ribcage with each breath (known
as retractions)

bluish skin around the mouth and nose (this is called cyanosis)

How Is Transient Tachypnea of the Newborn Diagnosed?

Transient tachypnea of the newborn is often diagnosed in the first few hours after
a baby is born. Transient means it does not last long (usually, less
than 24 hours) and tachypnea refers to the baby's very fast breathing
(more than 60 breaths per minute).

To diagnose a baby with TTN, the doctor will do a physical exam and also might
order one or all of the following:

Chest
X-ray. In a baby with TTN, an X-ray of the lungs will appear streaky
and fluid may be seen. The X-ray will otherwise appear normal.

Pulse
oximetry. A small piece of tape with an oxygen sensor is placed around
a baby's foot or hand, then connected to a monitor. This can tell doctors how well
the lungs are sending oxygen to the blood. Sometimes oxygen levels are checked with
a blood test. If oxygen levels are low, the baby might be given extra oxygen.

How Is Transient Tachypnea of the Newborn Treated?

Babies with transient tachypnea are watched closely. Doctors check their heart
rate, breathing rate, and oxygen levels to make sure breathing slows down and the
oxygen level is normal. Sometimes, babies are admitted to the neonatal
intensive care unit (NICU) for extra care.

Breathing Help

Some babies with TTN need extra oxygen. They get this through a small tube under
the nose called a
nasal cannula
.

A baby who gets extra oxygen but still struggles to breathe might need continuous
positive airway pressure (CPAP) to keep air flowing through the lungs. With
CPAP, a baby wears a special nasal cannula or a mask around the nose while a machine
continuously pushes a stream of pressurized air into the nose to help keep the lungs
open during breathing. Rarely, a baby will need support with a ventilator (a machine
that pumps air in and out of the lungs).

Nutrition

Nutrition can be a problem when a baby is breathing so fast that he or she can't
suck, swallow, and breathe at the same time. In that case,
intravenous
(IV) fluids will keep the baby hydrated while preventing blood sugar from
dipping too low.

If your baby has TTN and you want to breastfeed, talk to your doctor or a nurse
about maintaining your milk supply by using a breast pump while your newborn receives
IV fluids. Sometimes babies can take breast milk or formula through a nasogastric
(NG) or orogastric (OG) tube (a tube placed through the nose or mouth to deliver food
directly to the stomach). If your baby has one of these tubes, ask the doctor about
providing breast milk for your baby.

Symptoms of transient tachypnea usually improve within 24 to 72 hours. A baby
can be sent home from the hospital when the breathing is normal and he or she has
been feeding well for at least 24 hours.

Bringing Your Baby Home

Babies with TTN usually recover fully. But even after transient tachypnea goes
away, watch for signs of breathing problems and call your doctor right away if you
see any.

Call 911 if your baby:

has trouble breathing

breathes rapidly

has skin that looks blue

has skin in between the ribs or under the ribcage that pulls in during breathing